Table 3 Research agenda
Epidemiology
    Relative importance of environmental factors (exposure to sun, smoking, diet) in the pathogenesis of SLE
    Incidence, prevalence, and severity of SLE in various European populations? Is there a north-to-south gradient?
Pathogenesis
    Genetic factors for disease susceptibility and severity
    Effector mechanisms and repair of tissue injury
Early diagnosis—primary prevention
    Identification of patients at higher risk for SLE
    Feasibility of primary prevention
    Primary prevention of cardiovascular disease in high-risk patients (eg, aspirin, statins, others)
Initial diagnostic work-up and monitoring
    Minimum diagnostic work-up for suspected SLE
    Work-up for disease limited to a single organ (eg, skin, blood, others)
Diagnosis—prognosis
    Diagnostic criteria with improved sensitivity and specificity
    Classification criteria to identify subpopulations of SLE with distinct pathogenetic, clinical, and laboratory features and response to therapy
    Diagnostic algorithms for neuropsychiatric lupus
Treatment
    Indications and optimal targets for autologous stem-cell therapy in SLE
    Major indications for biological therapies in SLE (B cell depletion, inhibition of B cell differentiation, costimulation blockade, toleragens)
    Optimum management of membranous nephropathy
    Options for resistant disease involving major and non-major organs
    Indications, efficacy, toxicity of combined immunosuppressive and anticoagulant therapy for patients with antiphospholipid syndrome and SLE
Flares
    Mechanisms of flare: residual vs sub-clinical disease vs de novo flare
    Biomarkers for residual disease and for early relapse
    Optimal management of flares
Comorbidities
    Primary prevention of cardiovascular disease
    Primary prevention and screening for osteoporosis
    Strategies to increase compliance with therapy and preventive medicine
    Strategies to decrease morbidity and mortality from infection
    Validation of the Charlson Comorbidity score in SLE trials for optimal patient stratification
Neonatal lupus
    Epidemiology, risk factors and management
Pregnancy
    Impact of assisted fertilisation on disease activity
    Effect of maternal immunosuppressive treatment on offspring long-term outcome
Antiphospholipid antibodies
    Determine whether individuals with persistently positive antiphospholipid antibodies should receive prophylaxis (and type of) for thrombosis or pregnancy-related type morbidity
    Recommended treatment for pregnant patients with APS who had pregnancy loss on low-dose aspirin and heparin
Paediatric and adolescent SLE
    Epidemiology, optimal management and long-term outcome
Geriatric lupus
    Epidemiology, optimal management and long-term outcome